Osteomalaccia in afya

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low calcium and phosphate combined with the raised alkaline phosphatase point towards osteomalacia

''Basics''
    normal bony tissue but decreased mineral content
    rickets if when growing
    osteomalacia if after epiphysis fusion

''Types''
    vitamin D deficiency e.g. malabsorption, lack of sunlight, diet
    renal failure
    drug induced e.g. anticonvulsants
    vitamin D resistant; inherited
    liver disease, e.g. cirrhosis

''Features''
    rickets: knock-knee, bow leg, features of hypocalcaemia
    osteomalacia: bone pain, fractures, muscle tenderness, proximal myopathy

''Investigation''
    low calcium, phosphate, 25(OH) vitamin D
    raised alkaline phosphatase
    x-ray: children - cupped, ragged metaphyseal surfaces; adults - translucent bands (Looser's zones or pseudofractures)

''Treatment''
    calcium with vitamin D tablets

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